OR07-10
Outcomes of Transcatheter Aortic Valve Replacement In Patients With Amyloidosis: A Comparative Meta-Analysis
Presenter
Dr. Hasaan Ahmed, MD, Creighton University School of Medicine, Omaha, NE
Dr. Hasaan Ahmed, MD1, Mahmoud Ismayl, M.D.2, Anirudh Palicherla, MD3, Anthony Kashou, MD4, Jalal Dufani, MD1, Amjad Kabach, M.D.5, Dr. Andrew Michael Goldsweig, MD, MS, FSCAI6, Ahmed Aboeata, MD1 and Nandan Anavekar, MD2, (1)Creighton University School of Medicine, Omaha, NE, (2)Mayo Clinic College of Medicine and Science, Rochester, MN, (3)Creighton University , Omaha, NE, (4)Mayo Clinic Department of Cardiovascular Disease, Rochester, MN, (5)CHI Health Creighton University Medical Center, Omaha, NE, (6)University of Massachusetts - Baystate Medical Center, West Hartford, CT
Keywords: Complications, TAVI/TAVR/Aortic Valve and Vascular Access, Management, and Closure
Background
Amyloidosis is a prevalent comorbidity seen in those with aortic valve abnormalities. While transcatheter aortic valve replacement (TAVR) has become increasingly performed, outcomes of TAVR in those with coexisting amyloidosis remain not fully understood. We aimed to evaluate outcomes among patients with amyloidosis versus those without amyloidosis undergoing TAVR.
Methods
We searched several databases for studies comparing outcomes of TAVR in patients with amyloidosis to those without amyloidosis. We applied the generic inverse variance statistical method after extracting the odds ratios (OR) with the corresponding 95% confidence intervals (CI) to the pooled OR of each outcome in R studio. Outcomes assessed were acute kidney injury, all-cause mortality, arrhythmias, major bleeding, pacemaker insertion, and stroke. Results
A total of 3 studies were identified. There were significantly increased odds of stroke in those with amyloidosis undergoing TAVR compared to those without amyloidosis (OR 1.97; 95% CI 1.05 - 3.69). Odds of acute kidney injury (OR 1.19; 95% CI .81 - 1.75), all-cause mortality (OR 1.14; 95% CI 0.77 - 1.69), arrhythmias (OR 1.28; 95% CI .88 - 1.86), major bleeding (OR .75; 95% CI .48 - 1.18) and pacemaker implantation (OR 0.63; 95% CI .36 - 1.09) were similar between both groups.
Conclusions
This meta-analysis found patients with amyloidosis undergoing TAVR had increased odds of stroke, with otherwise similar odds of adverse events, compared to those without amyloidosis. These findings may serve as a framework for procedural considerations in amyloidosis patients requiring aortic valve interventions.
